胎儿泌尿系畸形的产前诊断与新生儿期治疗

Prenatal diagnosis and neonatal surgical treatment for fatus urinary malformations

目的探讨胎儿泌尿系畸形的产前诊断,以及新生儿早期治疗的可行性。方法回顾性分析我院产前诊断的13例泌尿系畸形患儿在新生儿期的诊治过程。结果1例肾盂输尿管连接处梗阻性肾盂积水术后并发泌尿系感染,经抗炎对症治疗痊愈,其他7例术后恢复良好。肾积水随访时间1个月至5年,生长发育良好,4例肾积水完全消失,其余肾集合系统分离值在5mm^12mm。多发性肾囊性变4例、重复肾重复输尿管畸形1例术后恢复良好,随访时间1个月至3年,生长发育良好。重复肾重复输尿管畸形术后随访1年7个月,肾输尿管B超检查正常。结论认为对于胎儿泌尿系畸形产前诊断是可能的,对重症泌尿系畸形在新生儿期治疗是必要的,也是安全可行的,它有利于改善先天性泌尿系畸形的预后。

Objective： To discuss the feasibility of prenatal diagnosis and neonatal surgical treatment for urinary malformations. Methods ： A retrspective analysis was made on 13 cases of prenatal diagnosis and neonatal surgical treatment for urinary malformations . Results ： 1 case bad urinary infection after operation in 8 bydronepbrosis, and tot good healing by anti - inflammatory. The other cases （7cases） recovered better. Patients of hydmnephrosis were followed - up for 1 months - 5 years and were good growth development. Their hydrops of kidney were completely disappear in 4 case. The pyelic separation values were 5mm - 12mm in others. Muhicystic dysplastic （4 cases） and duplicative kidney （lcase） got good healing and were followed - up for 1 months - 3 years . They were good growth development. There was being normal urinary uhrasonog raphy after operation in duplicative kidney. Conclusion： It is probably that urinary malformation is diagnosised in prenatal, and the treatment is also vecessary to severe urinary malformations . It can develop prognosis of urinary malformations.